Daily Dietary Protein Distribution Does Not Influence Changes in Body Composition During Weight Loss in Women of Reproductive Years with Overweight or Obesity: A Randomized Controlled Trial.

BACKGROUND: Preservation of fat-free mass (FFM) during intentional weight loss is challenging yet important to maintain a resting metabolic rate. A balanced protein distribution of 25-30 g per meal improves 24-h muscle protein synthesis, which may promote FFM maintenance and greater reductions in fat mass (FM) during weight loss in women. OBJECTIVES: We aimed to determine whether the daily dietary protein distribution pattern during energy restriction influences changes in body composition in women of reproductive age. We hypothesized that evenly distributing protein across meals compared with the usual intake pattern of consuming most of the protein at the dinner meal would be superior in preserving FFM while reducing FM during weight loss. METHODS: Healthy women (n = 43) aged 20-44 y with a BMI of 28-45 kg/m2 completed a randomized parallel feeding study testing 2 patterns of daily protein intake (even distribution across all meals compared with a skewed distribution with most protein consumed at the evening meal). Participants completed an 8-wk controlled 20% energy restriction (all foods provided), followed by an 8-wk self-choice phase in which participants were asked to maintain a similar diet and dietary pattern when purchasing and consuming their own foods. Body composition was measured at baseline, week 8, and week 16. Data were analyzed using mixed models. Statistical significance was set at P < 0.05. Data are presented as differences in least squares means ± SE. RESULTS: No significant main effects of group or group-by-time interactions were observed. All measures exhibited the main effect of time (P < 0.001). Overall, body weight, FFM, FM, and body fat percentage decreased 5.6 ± 0.4, 1.0 ± 0.2, 4.6 ± 0.4 kg, and 2.3 ± 0.2%, respectively, during this 16-wk study. CONCLUSION: Daily dietary protein distribution at a fixed protein level does not appear to influence changes in body composition during weight loss in women of reproductive age. CLINICAL TRIAL REGISTRY NUMBER AND WEBSITE WHERE IT WAS OBTAINED: NCT03202069 https://classic. CLINICALTRIALS: gov/ct2/show/NCT03202069.

Consumption of Dietary Guidelines for Americans Types and Amounts of Vegetables Increases Mean Subjective Happiness Scale Scores: A Randomized Controlled Trial.

BACKGROUND: The health benefits of diets rich in fruits and vegetables (FV) are well established. Recent observational and intervention research suggests that FV consumption may also exert a positive effect on psychological well-being. OBJECTIVE: This study aimed to assess changes in mean Subjective Happiness Scale (SHS) scores in response to consuming 2010-2015 Dietary Guidelines for Americans (DGA) recommended types and amounts of vegetables. It was hypothesized that increased vegetable consumption would increase mean SHS scores. DESIGN: This study investigated a secondary outcome of a randomized, parallel, nonblinded controlled trial with a 1:1 allocation ratio to a provided vegetable intervention or attention control group. PARTICIPANTS/SETTING: Men and women (n = 75) aged 18 to 65 years, body mass index ≥ 25, with low habitual vegetable consumption were recruited from Grand Forks, North Dakota, December 2016 to January 2018, for this community-based study. INTERVENTION: The vegetable intervention consisted of an 8-week feeding phase during which participants were provided with vegetables in DGA-recommended types and amounts. The attention control group was not provided vegetables but completed the same testing schedule as the vegetable intervention group. MAIN OUTCOME MEASURE: Mean SHS scores were assessed before and after the intervention. STATISTICAL ANALYSES: Mean SHS scores were analyzed using a 2-way factorial mixed linear model analysis of variance. RESULTS: A significant interaction between treatment and visit (P = .015) revealed greater mean SHS scores at week 8 than at baseline in the vegetable intervention group (+0.23 ± 0.11) (mean difference ± SE of the difference) but no change in the attention control group (-0.15 ± 0.11). CONCLUSIONS: Greater mean SHS scores were observed after increasing vegetable consumption to meet DGA recommendations, suggesting that adhering to DGA vegetable guidance may help promote psychological well-being.

Identification of Barriers to Adherence to a Weight Loss Diet in Women Using the Nominal Group Technique.

BACKGROUND: At any given time, a majority of women are engaged in some type of weight loss diet; however, these efforts are difficult to sustain for long-term weight control. Because women are more likely to develop obesity and suffer a greater severity of obesity-related health and economic consequences, we sought to identify the key factors that make adhering to a weight loss diet difficult for overweight/obese women. METHODS: Ten nominal group technique (NGT) sessions aimed at identifying perceived barriers to adherence to a weight loss diet were conducted as part of a weight loss study for overweight/obese women (n = 33) during the controlled feeding weight loss phase. RESULTS: Individual-level barriers to emerge from the sessions included knowing when to stop eating, being able to control cravings and emotional eating, and sustaining healthier dietary habits. Environmental-level barriers included family/social events that bring people together, especially those centered around food and drink, eating out, cost, and busy schedules. CONCLUSIONS: These findings offer a deeper understanding of barriers women find most salient to adhering to a weight loss diet, providing direction for the clinical application of weight loss programs.

Liking and Acceptability of Whole Grains Increases with a 6-Week Exposure but Preferences for Foods Varying in Taste and Fat Content Are Not Altered: A Randomized Controlled Trial.

BACKGROUND: Since 2005, the Dietary Guidelines for Americans have recommended consuming at least half of total grains as whole grains (WGs) for optimal health benefits; however, consumption of WGs falls far short of recommended amounts. OBJECTIVE: This study aimed to evaluate the effect of mere exposure to WGs on liking, acceptability, and consumption of WG foods and to determine if exposure to WG would influence liking and wanting for other foods varying in fat content and sweet taste. METHODS: Healthy, self-identified low WG consumers (n = 45) were randomly assigned to either a 6-wk WG intervention or a refined grain (RG) control condition during which they received a weekly market basket of grain products to incorporate into daily meals and snacks. Consumption of grain products was measured by weekly logs and weigh-backs. A sensory evaluation protocol was conducted at baseline and week 6 to evaluate changes in perception of grain products. Computer tasks designed to measure liking and wanting for other foods varying in high/low-fat content and sweet/savory taste were also completed at baseline and week 6. RESULTS: Participants in the WG group significantly increased WG consumption. Exposure to WG products resulted in improved ratings of liking, flavor, texture, and willingness to include WG in the regular diet. No significant changes in liking or wanting for foods representing high-fat sweet (HFSW), low-fat sweet (LFSW), high-fat savory (HFSA), or low-fat savory (LFSA) categories were found in the WG group. In contrast, exposure to RG foods resulted in an increased explicit wanting for HFSW and LFSW and a decreased wanting for HFSA foods. CONCLUSIONS: Mere exposure to WG foods represents a feasible and easily applied behavioral strategy for increasing consumption of WGs. Encouraging consumers to focus on enjoyment of the taste may be more effective than emphasizing the health benefits of WG consumption. This trial was registered at clinicaltrials.gov as NCT01403857.

Significant reduction in heart rate variability is a feature of acute decompensation of cirrhosis and predicts 90-day mortality.

BACKGROUND: Heart rate variability (HRV) is reduced in cirrhosis and in conditions of systemic inflammation. Whether HRV is associated with cirrhosis decompensation and development of acute-on-chronic liver failure (ACLF) is unknown. AIMS: To (a) validate wireless remote HRV monitoring in cirrhosis decompensation; (b) determine if severely reduced HRV is a surrogate for inflammation and progression of cirrhosis decompensation; (c) assess if measuring HRV determines prognosis in cirrhosis decompensation. METHODS: One hundred and eleven patients at risk of cirrhosis decompensation at two clinical sites were monitored for HRV. Standard deviation of all normal beat-beat intervals (SDNN) reflecting HRV was assessed using remote monitoring (Isansys Lifetouch) and/or Holter ECG recording. Clinical outcomes and major prognostic scores were recorded during 90-day follow-up. RESULTS: Reduced HRV denoted by lower baseline SDNN, correlated with severity of decompensation (median 14 (IQR 11-23) vs 33 (25-42); P < 0.001, decompensated patients vs stable outpatient cirrhosis). Furthermore, SDNN was significantly lower in patients developing ACLF compared to those with only decompensation (median 10 (IQR9-12) vs 16 (11-24); P = 0.02), and correlated inversely with MELD and Child-Pugh scores, and C-reactive protein (all P < 0.0001) and white cell count (P < 0.001). SDNN predicted disease progression on repeat measures and appeared an independent predictor of 90-day mortality (12 patients). An SDNN cut-off of 13.25 ms had a 98% negative predictive value. CONCLUSIONS: This study demonstrates that remote wireless HRV monitoring identifies cirrhosis patients at high risk of developing ACLF and death, and suggests such monitoring might guide the need for early intervention in such patients. Clinical Trial number: NIHR clinical research network CPMS ID 4949.

Patrones comportamentales de fóridos (Diptera: Phoridae) parasitoides de Atta colombica (Hymenoptera: Formicidae) / Behavioral patterns of parasitoid phorids (Diptera: Phoridae) of Atta colombica (Hymenoptera: Formicidae)

ResumenEl éxito de las interacciones parasitoide-hospedero está determinado por la conducta de búsqueda, reconocimiento, ataque y defensa que despliegan los participantes en dicha interacción. Para comprender los patrones comportamentales entre los fóridos parasitoides y su hospedero, Atta colombica, se realizaron observaciones en un fragmento de bosque en el departamento de Córdoba, con un esfuerzo muestral de 186 horas en tres nidos de esta. Se recolectaron fóridos, hormigas atacadas y la carga que llevaban. En total se capturaron 52 individuos de Eibesfeldtphora attae y 54 de Apocephalus colombicus. Se observaron diferencias en cuanto a la forma de ataque y el microhábitat preferido por los parasitoides. No hubo preferencia aparente por el tamaño de las hormigas que atacaron los fóridos, pero seleccionaron cargas de mayor tamaño para posarse sobre ellas. Cuando las hormigas respondieron al ataque, emplearon defensas individuales (adoptando posiciones o aumentando su velocidad) o grupales (cuando hormigas vecinas atacaban al parasitoide). Los fóridos parasitoides especializan su conducta con el fin de garantizar un ataque exitoso sobre su hospedero, quien responde modificando su comportamiento según el parasitoide atacante.

AbstractIn ecology, the success of parasitoid-host interactions is determined by the behavior of seeking, recognition, attack and defense deployed by the participants in the interaction. Our study aimed to understand the behavioral patterns between parasitoid phorids and their host Atta colombica from a forest fragment of Córdoba department, Colombia. We observed three nests of Atta colombica, from December 2013 to Januray 2015 (including dry and rainy seasons), for a total effort of 189 hours. We observed Phorids, their attacks to ants and collected their loads; we also considered differences in the way the parasitoids attacked and observed the microhabitat they preferred. A total of 52 individuals of Eibesfeldtphora attae and 54 of Apocephalus colombicus were collected. Apparently there was no preference for the size of the ants that were attacked by phorids, but larger loads were selected to land on them. When the ants responded to the phorid attack, they used individual defenses (adopting positions or increasing their speed) or grupal defenses (closer ants attacking the phorid). Parasitoid phorids have specialized their behavior, in order to ensure a successful attack on their host, who responded by modifying its behavior, according to the attacker (parasitoid).

The Effects of Moderate Whole Grain Consumption on Fasting Glucose and Lipids, Gastrointestinal Symptoms, and Microbiota.

This study was designed to determine if providing wheat, corn, and rice as whole (WG) or refined grains (RG) under free-living conditions will change parameters of health over a six-week intervention in healthy, habitual non-WG consumers. Measurements of body composition, fecal microbiota, fasting blood glucose, total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), and triglycerides were made at baseline and post intervention. Subjects were given adequate servings of either WG or RG products based on their caloric need and asked to keep records of grain consumption, bowel movements, and GI symptoms weekly. After six weeks, subjects repeated baseline testing. Significant decreases in total, LDL, and non-HDL cholesterol were seen after the WG treatments but were not observed in the RG treatment. During Week 6, bowel movement frequency increased with increased WG consumption. No significant differences in microbiota were seen between baseline and post intervention, although, abundance of order Erysipelotrichales increased in RG subjects who ate more than 50% of the RG market basket products. Increasing consumption of WGs can alter parameters of health, but more research is needed to better elucidate the relationship between the amount consumed and the health-related outcome.

Intraspecific variation in body size and shape in an andean highland anole species, Anolis ventrimaculatus (Squamata: Dactyloidae).

Variation in body characteristics related to lizard locomotion has been poorly studied at the intraspecific level in Anolis species. Local adaptation due to habitat heterogeneity has been reported in some island species. However, studies of mainland species are particularly scarce and suggest different patterns: high variability among highland lizards and poorly differentiated populations in one Amazonian species. We characterized inter population variation of body size and shape in the highland Andean Anolis ventrimaculatus, an endemic species from Western Colombia. A total of 15 morphometric variables were measured in specimens from the reptile collection of the Instituto de Ciencias Naturales, Universidad Nacional, Colombia. The study included individuals from seven different highland localities. We found size and shape sexual dimorphism, both of which varied among localities. Patterns of variation in body proportions among populations were different in both males and females, suggesting that either sexual or natural selective factors are different in each locality and between sexes. Since this species exhibits a fragmented distribution in highlands, genetic divergence may also be a causal factor of the observed variation. Ecological, behavioral, additional morphological as well as phylogenetic data, may help to understand the evolutionary processes behind the geographic patterns found in this species.

Breeding, growth and exploitation of brachyplatystoma rousseauxii castelnau, 1855 in the caqueta river, Colombia

The main life history traits of the large Amazonian migratory catfish Brachyplatystoma rousseauxii were determined in the Caqueta River, Colombia. The breeding season occurred during the rising and falling water periods. The size at first sexual maturity was significantly larger for females (88.5 cm Ls) than males (81.7 cm). Both males and females reproduce for the first time between their third and fourth year. The growth characteristics were estimated using length frequency analyses. Females grew systematically larger than males, the difference being about 9% after the first year and increasing to 12% for ten years old individuals. Mortality estimates, calculated from different models, some taking into account the effect of body size, ranged from 0.32 to 0.42 year-1 for natural mortality and from 0.72 to 0.82 year-1 for fishing mortality, indicating high fishing pressure in the Caqueta River, higher than in the Peruvian Amazon. Resulting exploitation rates (0.63 to 0.72) pointed towards overexploitation of the species in the Caqueta. The situation calls for a concerted management between the countries sharing this resource (Brazil, Colombia, and Peru) and potential solutions are proposed.

Se determinaron las principales características del ciclo biológico de dorado Brachyplatystoma rousseauxii en el río Caquetá, Colombia. La época reproductiva ocurre durante la transición del período de aguas altas a aguas en descenso. La talla de primera madurez sexual fue significativamente mayor en hembras (88,5 cm Ls) que en machos (81,7 cm). Tanto hembras como machos se reproducen por primera vez entre su tercer y cuarto año de vida. Los parámetros de crecimiento fueron estimados mediante el análisis de frecuencia de tallas. Las hembras alcanzan un mayor tamaño que los machos, con una diferencia de cerca del 9% en el primer año que luego aumenta hasta un 12% en el décimo año de edad. La estimación de mortalidad, calculada a partir de diferentes modelos, variaron entre 0,32 a 0,42 años-1 para la mortalidad natural y 0,72 a 0,82 años-1 para la mortalidad por pesca, lo que indica una alta presión de la pesca en el río Caquetá, mucho más elevada que en la Amazonía peruana. Las tasas de explotación resultantes (0,63 a 0,72) para el río Caquetá, señalan una sobre-utilización del recurso. La situación exige una gestión concertada entre los países que comparten y utilizan con elevada frecuencia este recurso amazónico (Brasil, Colombia y Perú), por lo que se proponen posibles estrategias de solución.

Intraspecific variation in body size and shape in an Andean highland anole species, Anolis ventrimaculatus (Squamata: Dactyloidae)

Variation in body characteristics related to lizard locomotion has been poorly studied at the intraspecific level in Anolis species. Local adaptation due to habitat heterogeneity has been reported in some island species. However, studies of mainland species are particularly scarce and suggest different patterns: high variability among highland lizards and poorly differentiated populations in one Amazonian species. We characterized inter population variation of body size and shape in the highland Andean Anolis ventrimaculatus, an endemic species from Western Colombia. A total of 15 morphometric variables were measured in specimens from the reptile collection of the Instituto de Ciencias Naturales, Universidad Nacional, Colombia. The study included individuals from seven different highland localities. We found size and shape sexual dimorphism, both of which varied among localities. Patterns of variation in body proportions among populations were different in both males and females, suggesting that either sexual or natural selective factors are different in each locality and between sexes. Since this species exhibits a fragmented distribution in highlands, genetic divergence may also be a causal factor of the observed variation. Ecological, behavioral, additional morphological as well as phylogenetic data, may help to understand the evolutionary processes behind the geographic patterns found in this species.

La diversificación fenotípica al interior de una especie en características de dimensiones corporales relacionadas con la locomoción de los lagartos, se ha estudiado poco en especies de Anolis. Los datos de algunas especies de isla revelan patrones distintos de variación geográfica y sugieren que la adaptación local, debida a la heterogeneidad del hábitat, ocurre a este nivel. Los estudios de especies de continente son particularmente escasos y sugieren patrones distintos: un lagarto altoandino altamente variable y poblaciones poco diferenciadas en una especie amazónica. Caracterizamos la variación inter poblacional en el tamaño y forma del cuerpo del lagarto altoandino Anolis ventrimaculatus, especie endémica del Oeste de Colombia. Encontramos variación geográfica en el dimorfismo sexual en tamaño y forma. El patrón de variación en las proporciones corporales entre poblaciones fue distinto en machos y en hembras, sugiriendo que las presiones de selección sexual o natural son diferentes en cada localidad. Dado que la especie exhibe una distribución fragmentada en alta montaña, la divergencia genética entre poblaciones puede ser otro factor causal de la variación observada. Datos ecológicos, etológicos y morfológicos adicionales, así como información filogenética puede contribuir al entendimiento de los procesos evolutivos responsables del patrón de variación geográfica encontrado en esta especie.

Diferenciales de salud y una aproximación mediante el empleo del coeficiente de Gini y el índice de concentración en las provincias cubanas, 2002-2008 / Health's differentials and a approaching to use of Gini's coefficient and the rate of concentration in the Cuban provinces, 2002-2008

INTRODUCCIÓN: No existen muchas publicaciones científicas que aborden los diferenciales de salud entre las provincias de Cuba, ni que documenten los principales factores que impactaron en los resultados de salud de la población durante el período 1989 - 2000. En el año 2002 Fidel Castro destacó la existencia de una serie de errores de conducción y organización durante ese periodo, que a su criterio debilitaron el sistema de salud cubano y propiciaron la aparición de "determinadas desigualdades". OBJETIVO: Describir los principales diferenciales de salud existentes entre los distintos territorios de Cuba (factores determinantes de la salud de los cubanos) durante el período estudiado (2002-2008). MÉTODOS: Se utilizó como unidad geográfica a la provincia. Las catorce provincias cubanas fueron estratificadas sobre la base de tres ejes fundamentales: demográfico, económico y condiciones de vida, con vista a identificar posibles diferenciales de salud (inequidades en salud y en servicios de salud) mediante el empleo de la técnica del coeficiente de Gini y del índice de concentración. RESULTADOS: Se muestran los principales factores o variables con diferenciales de salud presentes en el país por provincias durante el período estudiado, se identificaron los factores o variables que mayores diferenciales exhibieron por cada uno de los ejes demográfico (densidad poblacional), económico (producción mercantil) y condiciones de vida (cobertura sanitaria). Se definen las diferencias existentes entre cada una de las provincias y por regiones y las características muy particulares de la capital cubana como provincia. CONCLUSIONES: Se confirma la hipótesis de que a pesar de la férrea voluntad política del estado de evitar inequidades en salud, aún se observan diferenciales no importantes en el comportamiento de las variables estudiadas por cada uno de los ejes de análisis entre provincias. No obstante, existen diferencias entre el comportamiento de esos diferenciales de acuerdo con los ejes de análisis, aspectos que deben ser y fueron considerados durante el proceso de diseño de políticas sanitarias, de reorganización de los servicios de salud, de formación de capital humano y de abordaje intersectorial de los determinantes no médicos de la salud durante los años más duros del período especial, lo que viene a confirmar el modelo teórico desarrollado previamente por los autores.

INTRODUCTION: There is a lack of scientific publications approaching the health differentials among the Cuban provinces and of to document the leading factors with impact on the health results in the population during the period 1989-2000. In 2002 Fidel Castro Rus emphasized on the existence of errors in the management and organization during above mentioned period, that according to his criterion to weaken the Cuban health system and led to appearance of "determined inequalities". OBJECTIVE: To describe the leading health differentials present among the different Cuban territories (determinant health factors for Cubans) during the study period (2002-2008). METHODS: The province was used as geographical unit. The fourteen Cuban provinces were stratified on the base of the three fundamental bases: demographic, economic and life conditions to identify the potential health differentials (inequalities in health and in its services) using the Gini's coefficient technique and the concentration's index. RESULTS: The leading factors or variables with health differentials present in our country by provinces during the study period are showed, identifying the factors or variables with greater differentials by each of the demographic bases (population density), economic (commercial production) and life conditions (health coverage). The differences present among each of the provinces and regions are defined as well as the very particular characteristics of the Cuban capital as province. CONCLUSIONS: The hypothesis that despite the strong political and state will to avoid health inequalities, still there are no-significant differences in the behavior of study variables by each of the bases of analysis among provinces. Nevertheless, there differences among the behavior of such differentials according to analysis's bases, features that be and were considered during the process of health politics design, of reorganization of health services, of human resource training and the intersectorial approach of non-health physicians determinants during the more hard year of special period, confirming the theoretical model previously developed by the authors.

Evaluación de la historia clínica de pacientes hipertensos de acuerdo a indicadores de calidad del programa de hipertensión arterial, Clínica Assbasalud La Enea (ESE) 2004-2007 / Medical records evaluation pf hypertensive patients according to indicators of quality of the hipertension program, ASSBASALUD Enea (ESE) clinic 2004-2007

Objetivo: Evaluar la calidad de la historia clínica del programa de hipertensión arterial en los pacientes inscritos en la clínica la ENEA de ASSBASALUD ESE (Centros urbanos de Atención en Seguridad Social, Bienestar y Salud, Empresa Social del Estado, Manizales, Colombia) entre los años 2005-2007. Materiales y métodos: El estudio aplicado fue de corte transversal y se ejecutó revisando las historias clínicas de los pacientes hipertensos que asisten al programa de seguimiento de la hipertensión arterial en la clínica mencionada. Se estudiaron variables como: edad, escolaridad, seguridad social, sexo, tarjetas elaboradas, asistencia al programa, asistencia al control, historia clínica, órgano blanco, guías de atención. Resultados: En las historias clínicas no aparece registrado el dato de escolaridad (94,5 porciento), en la revisión del órgano blanco, se encontró solo en 177 (77 por ciento), valorado el órgano blanco riñón, el corazón en 116 (53,5 por ciento) pacientes, y la retina en 64(29,5 por ciento). Además 92,6 por ciento de los pacientes tenían diligenciadas sus tarjetas de control, solo el 39,6 por ciento asisten a los controles. Conclusiones: La mayor falencia en la evaluación del paciente hipertenso es cómo se enfocan a estos pacientes en los niveles de atención básica que lleva a un seguimiento erróneo...

Risk factors for nosocomial infections in selected neonatal intensive care units in Colombia, South America.

OBJECTIVE: This study was designed to identify risk factors for nosocomial infections among infants admitted into eight neonatal intensive care units in Colombia. Knowledge of modifiable risk factors could be used to guide the design of interventions to prevent the problem. STUDY DESIGN: Data were collected prospectively from eight neonatal units. Nosocomial infection was defined as culture-proven infection diagnosed after 72 hours of hospitalization, resulting in treatment with antibiotics for >3 days. Associations were expressed as odds ratios. Logistic regression was used to adjust for potential confounders. RESULTS: From a total of 1504 eligible infants, 80 were treated for 127 episodes of nosocomial infection. Logistic regression analysis identified the combined exposure to postnatal steroids and H2-blockers, and use of oral gastric tubes for enteral nutrition as risk factors significantly associated with nosocomial infection. CONCLUSION: Nosocomial infections in Colombian neonatal intensive care units were associated with modifiable risk factors including use of postnatal steroids and H2-blockers.

Epidemiology of nosocomial infections in selected neonatal intensive care units in Colombia, South America.

OBJECTIVE: The epidemiology of nosocomial infections (NI) in neonatal intensive care units in developing countries has been poorly studied. We conducted a prospective study in selected neonatal units in Colombia, SA, to describe the incidence rate, causative organisms, and interinstitutional differences. STUDY DESIGN: Data were collected prospectively from February 20 to August 30, 2001 from eight neonatal units. NI was defined as culture-proven infection diagnosed after 72 h of hospitalization, resulting in treatment with antibiotics for >3 days. Linear regression models were used to describe associations between institutional variables and NI rates. RESULTS: A total of 1504 infants were hospitalized for more than 72 h, and therefore, at risk for NI. Of all, 127 infections were reported among 80 patients (5.3%). The incidence density rate was 6.2 per 1000 patient-days. Bloodstream infections accounted for 78% of NIs. Gram-negative organisms predominated over gram-positive organisms (55 vs 38%) and were prevalent in infants < or =2000 g (54%). The most common pathogens were Staphylococcus epidermidis (26%) and Klebsiella pneumonia (12%). CONCLUSION: Gram-negative organisms predominate in Colombia among infants <2000 g. The emergence of gram-negative organisms and their associated risk factors requires further study.

Circulación del virus de la hepatitis B en una comunidad / Circulation of the Hepatitis B Virus in a Community

Se estudió a 52 familias atendidas en el Consultorio Médico nr 2 del Policlínico de Mulgoba, ubicado en el municipio Boyeros de La Habana, en busca del antígeno de superficie de la hepatitis B y de los anticuerpos en el suero contra él. Se encontró un individuo positivo de antígeno de superficie, en tanto hubo 16,79 por ciento de personas con anticuerpos específicos, sin antecedentes de hepatitis, vacunación o prácticas de riesgo. La media geométrica de la concentración de anticuerpos en mujeres y hombres fue de 34,05 y 26,99 UI/L, respectivamente, mientras que en niñas y niños resultó ser de 194,61 y 94,64 UI/L, en ese orden. En 6 de las familias, más de un miembro era positivo de anticuerpos. La cobertura del programa actual de inmunización se extendió a todos los niños estudiados, de los cuales 100 por ciento tuvieron respuestas protectoras (>10 UI/L) y 65 por ciento hiperrespuestas (>100 UI/L), sin encontrarse portadores del virus entre ellos